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BackgroundChemicals may lead to acute liver injuries, posing a serious threat to human health. Achieving the precise safety profile of a compound is challenging due to the complex and expensive testing procedures. In silico approaches will aid in identifying the potential risk of drug candidates in the initial stage of drug development and thus mitigating the developmental cost.MethodsIn current studies, QSAR models were developed for hepatotoxicity predictions using the ensemble strategy to integrate machine learning (ML) and deep learning (DL) algorithms using various molecular features. A large dataset of 2588 chemicals and drugs was randomly divided into training (80%) and test (20%) sets, followed by the training of individual base models using diverse machine learning or deep learning based on three different kinds of descriptors and fingerprints. Feature selection approaches were employed to proceed with model optimizations based on the model performance. Hybrid ensemble approaches were further utilized to determine the method with the best performance.ResultsThe voting ensemble classifier emerged as the optimal model, achieving an excellent prediction accuracy of 80.26%, AUC of 82.84%, and recall of over 93% followed by bagging and stacking ensemble classifiers method. The model was further verified by an external test set, internal 10-fold cross-validation, and rigorous benchmark training, exhibiting much better reliability than the published models.ConclusionThe proposed ensemble model offers a dependable assessment with a good performance for the prediction regarding the risk of chemicals and drugs to induce liver damage.

IntroductionIn most instances, liver transplantation (LT) is the only available treatment for end‐stage liver diseases. However, LT could also induce serious liver diseases or injury, and the underlying mechanisms of LT-induced complications remain largely unknown, especially the mechanisms of the dysfunction of the immune system mediated by long noncoding RNAs (lncRNAs).MethodsIn this study, we globally analyzed the proportion of immune cells by using the transcriptome sequencing data (RNA-seq) of needle-core liver biopsies from pre- and post-transplantation recipients. Dysregulated lncRNAs were found to be correlated with the altered fractions of immune cells. We finally explored the potential targets of dysregulated lncRNAs and analyzed their functions in LT.ResultsWe found that in the samples, some immune cells changed significantly after LT, including CD4 T cells, NK cells and mast cells. The proportion of macrophages in different polarization states also changed significantly, with M0 macrophages increasing and M2 macrophages decreasing. Through weighted gene co-expression network analysis (WGCNA), 7 gene expression modules related to LT were identified. These modules were related to changes in the proportion of different immune cells. The functions of these modules represent the response modes of different functional genes after LT. Among these modules, MEtan and MEyellow modules were primarily enriched in apoptosis and inflammatory pathways. Twelve immunity-related lncRNAs were identified for the first time, and the regulatory network co-changing with immune cells was also identified. The co-expressed genes of these lncRNAs were highly enriched in apoptosis-related pathways. Many apoptosis-related genes were found to be up-regulated after LT.DiscussionIn summary, we speculated that the expression and regulation of these apoptotic genes may be related to the changes in the proportion of immune cells. Some of these lncRNAs and apoptosis-related genes have been reported to be related to cell proliferation and apoptosis. They are also potential biomarkers or therapeutic targets.

Background: Chemicalsmay lead to acute liver injuries, posing a serious threat to human health. Achieving the precise safety profile of a compound is challenging due to the complex and expensive testing procedures. In silico approaches will aid in identifying the potential risk of drug candidates in the initial stage of drug development and thus mitigating the developmental cost. Methods: In current studies, QSAR models were developed for hepatotoxicity predictions using the ensemble strategy to integrate machine learning (ML) and deep learning (DL) algorithms using various molecular features. A large dataset of 2588 chemicals and drugswas randomly divided into training (80%) and test (20%) sets, followed by the training of individual base models using diverse machine learning or deep learning based on three different kinds of descriptors and fingerprints. Feature selection approaches were employed to proceed with model optimizations based on the model performance. Hybrid ensemble approaches were further utilized to determine the method with the best performance. Results: The voting ensemble classifier emerged as the optimal model, achieving an excellent prediction accuracy of 80.26%, AUC of 82.84%, and recall of over 93% followed by bagging and stacking ensemble classifiers method. The model was further verified by an external test set, internal 10-fold cross-validation, and rigorous benchmark training, exhibiting much better reliability than the published models. Conclusion: The proposed ensemble model offers a dependable assessment with a good performance for the prediction regarding the risk of chemicals and drugs to induce liver damage. [ABSTRACT FROM AUTHOR]

Background: Surgical site infection is one of the most common complications of conventional laparoscopic surgery. Preventing infection of the incision is particularly important.Objective: To discuss how to prevent the occurrence of surgical site infection after contaminated abdominal surgery.Methods: Five hundred and fifty-one surgery patients with ``contaminated abdominal incisions'' from January 2011 to May 2013 were analyzed in terms of the preventative treatment, and summarized for surgical site infection. Subcutaneous tissue flushed with normal saline + hydrogen peroxide before suturing in the intervention 1 group; subcutaneous tissue flushed with normal saline + 0.5% povidone-iodine before suturing in the intervention 2 group.Results: When subcutaneous fat was contaminated to a depth of ≤ 2.5 cm, the rates of surgical site infection in the control group and the intervention groups showed no significant difference (P > 0.05). When subcutaneous fat was contaminated to a depth of ≥ 3.0 cm, the rate of surgical site infection in the control group compared with the intervention one group was not statistically different (P > 0.05). The rate of surgical site infection in the control group compared with the intervention two group was statistical significant (P < 0.05). The rate of surgical site infection in the intervention one group compared with the intervention two group was statistical significant (P < 0.05).Conclusions: Preoperative control of the blood sugar; correction of anemia and the hypoalbuminemia; use of intraoperative the high-frequency electrotome; irrigation of the incision with plenty of physiological saline +$ iodophor before suturing the subcutaneous fat layer were key to effectively preventing infection in contaminated abdominal incisions. [ABSTRACT FROM AUTHOR]

Objective: To detect the expression of follicuLar helper T cells (Tfh) and interleukin-21 (IL-21) in the peripheral blood of patients with hepatic echinococcosis and healthy controls, so as to explore the associations of Tfh and IL-21 expression with the progression of hepatic echinococcosis., Methods: Fifty cases of hepatic echinococcosis and healthy controls were collected from Qinghai Provincial People's Hospital, respectively. Flow cytometry was used to detect the expression of Tfh cells in the peripheral blood of hepatic echinococcosis patients and healthy controls, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum IL-21 expression in hepatic echinococcosis patients and healthy controls. The correlation between Tfh cell expression and serum IL-21 level was examined in the patients with hepatic echinococcosis., Results: Flow cytometry detected a higher percentage of CD4 + CXCR5 + T cells (18.49% ± 5.67% vs. 16.18% ± 4.04%, P < 0.05), CD4 + CXCR5 + PD-1 + T cells (4.94% ± 1.91% vs. 2.29% ± 0.79%, P < 0.05) and CD4 + CXCR5 + ICOS + PD-1 + T cells (30.93% ± 24.10% vs. 21.07% ± 14.25%, P < 0.05) in hepatic echinococcosis patients than in healthy controls, and no significant difference was seen in the percentage of CD4 + CRCR5 + ICOS + T cells between the patients and controls (0.29% ± 0.32% vs. 0.25% ± 0.31%, P > 0.05) . The serum IL-21 level was significantly higher in the patients with hepatic echinococcosis than in healthy controls ([ 293.35 ± 2 03.65) pg/mL vs. (192.72 ± 70.09) pg/mL, P < 0.05]; however, there was no correlation between the Tfh cell expression and serum IL-21 level in patients with hepatic echinococcosis ( P > 0.05)., Conclusions: The expression of peripheral blood Tfh cells and serum IL-21 is elevated in patients with hepatic echinococcosis, and Tfh cells and IL-21 may contribute to the progression of hepatic echinococcosis.

The hepatic echinococcosis is an anthropozoonosis and caused by the larva of Echinococcus . The main pathogenic type of Echinococcus in China is E. granulosus and E. multilocularis , which cause cystic echinococcosis and alveolar echinococcosis respectively. At present, the treatment of hepatic echinococcosis has made great progress, but there are still some difficulties in the treatment of complex echinococcosis, especially of the cases existing one or more complications, and the focus of infection encroaching the hepatic portal, important vessels and bile vessel. This paper based on the literature reports and clinical experiences in recent years, puts forward the surgical treatment strategy for complex hepatic echinococcosis.

Objective: To investigate the distribution characteristics of gallbladder diseases in children with hepatic alveolar echinococcosis, and to analyze the related factors for hepatic alveolar echinococcosis and gallbladder diseases., Methods: The clinical data of hepatic alveolar echinococcosis patients under 18 years were collected in Qinghai Provincial People's Hospital-from January 2012 to December 2017, and the gallbladder-related complications in the surgically treated patients with hepatic al-veolar echinococcosis were analyzed., Results: The clinical data of 51 child patients with hepatic alveolar echinococcosis were collected and analyzed. According to the PNM classification criteria of WHO, P1, P2 and P3 in the 51 patients accounted for 37.25% (19/51), 41.18% (21/51) and 19.60% (10/51), respectively. According to the diagnostic criteria (WS 257-2006) of China for echinococcosis, the patients of infiltration type, calcification type and liquefaction cavitary type accounted for 66.67% (34/51), 21.57% (11/51) and 11.76% (6/51), respectively. Among the 51 patients, 78.43% (40/51) of the patients had clinical symptoms of biliary tract disease, and 58.82% (30/51) had gallbladder-related complications. The operations were performed on 40 patients, and 77.50% (31/40) of them had the postoperative complications. The results of binary multivariate logistic regression analysis showed that the clinical image classification, the liver segment distribution, size, location and number of lesions of hepatic alveolar echinococcosis were important correlative factors for the occurrence of gallbladder complications in hepatic alveolar echinococcosispatients., Conclusions: The incidence of complications related to gallbladder diseases is higher in the children with hepatic alveolar echinococcosis in Qinghai Province, and it has great influence on the operation mode and the occurrence and prognosis of postoperative complications. The early diagnosis and treatment of alveolar echinococcosis in children is particularly important.

Echinococcosis is a zoonotic parasitic disease caused by the larvae of Echinococcus granulosus and E. multiltilocularis , which mainly violate the liver. And the surgical treatment is an important method to cure the disease at present. However, there are many surgical methods for the treatment of hepatic echinococcosis, and different surgeries with different indications and risks. With the standard of precision surgery and no tumor surgery, the surgical operation is more precise. The innovation of surgical methods makes the operation of curing complex hepatic echinococcosis become true. This paper reviews the surgical methods and indications in clinical practice so as to provide some help for better choice.

Objective: To determine the susceptibility genes and resistance genes in HLA-DRB1 alleles in Tibetan patients with cystic and alveolar hydatid diseases, so as to provide the references for the research of the genetic characteristics and infection mechanism of Tibetan hydatid diseases., Methods: The case control method was applied. The Tibetan patients with cystic and alveolar hydatid diseases (63 and 73 cases respectively) in Yushu and Guoluo Tibetan Autonomous Prefecture, and unrelated healthy people (60 cases) in this area were selected as the study subjects. The polymerase chain reaction-sequence based typing (PCR-SBT) technique was applied for genotyping of HLA-DRB1, and the comparison of the gene frequency., Results: The frequency of HLA-DRB1*04 in the alveolar/cystic echinococcosis group was lower than that in the control group ( χ 2 = 4.71, 4.31, both P < 0.05)., Conclusions: HLA-DRB1*04 genotypes may be associated with the resistance of cystic and alveolar echinococcosis and its resistance genes.